Body Mass Index Mediates the Direct Association of Subjective Social Status and Hypertension in a West African Immigrant Sample

Abstract

The inverse association between social status (SSS) and hypertension often observed in native-born populations may not hold among immigrants from regions where larger bodies are markers of success. Qualitative evidence suggests that many African immigrant groups view larger body size as a marker of social status. The current study examined the relationships between subjective social status, body mass index and hypertension in a community sample of 218 West African Fulani immigrants living in New York City. Over a third of the sample met criteria for hypertension. Higher subjective social status within the Fulani community was associated with higher likelihood of hypertension. B ody mass index fully mediated this association. Member checking revealed a community narrative in which being heavy indicated higher status. These findings provide the first quantitative evidence that aesthetic markers of status within African immigrant communities may comprise risks to cardiovascular health.

Note:
Funding Information: This work was supported by the NIH/NICHD, grant number 1R15HD079008, awarded to the first author.

Declaration of Interests: The authors have no conflicts of interests to declare.

Ethics Approval Statement: The study protocol and all procedures were approved by the CBO’s executive committee and the Institutional Review Board of Fordham University.

Keywords: immigrants, West Africa, subjective social status, hypertension, body mass index